ZocdocAnswersI had fresh bright red PV bleed, what could be wrong?

Question

I had fresh bright red PV bleed, what could be wrong?

I woke up this morning and went to the toilet when I noticed bright red fresh blood on the toilet paper and dripping into the toilet. It took about 4 or 5 wipes to stop it. There was a significant amount of blood. My period isn't due for over a week which run like clockwork. This has never happened before and I am normally fit and healthy. I am on the pill so don't think I could be pregnant, I last had sex in August but have had periods since. The bleeding has now stopped but I'm just a bit worried about what it means. I have been on the same pill since I was 15 and I'm now 21.

Answer

I would definitely go to see your primary care doctor or your OB GYN doctor about this issue, as any case of unexpected vaginal bleeding needs to be investigated. One possibility is a urinary tract infection. This can cause spotting on toilet paper (although it sounds like maybe you had more than spotting, which would make a urine infection somewhat less likely), usually together with pain or burning with urination. Another cause would be break through bleeding. This is a type of irregular bleeding that frequently occurs in people taking oral contraceptive pills. The most typical cause of this would be a missed dose or other irregularity in how you have been taking the pill. However, it can occur even if you are taking the pill exactly as prescribed. It can also occur at any point, even though you've been taking the pill for a number of years without having this problem. The fact that you have been taking the pill and have had periods since last having sex in August makes a pregnancy very unlikely, but not entirely impossible. Therefore, as part of your work up I have no doubt that your doctor will want to perform a simple urine pregnancy test to rule out this possibility.

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